{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:20:53Z","timestamp":1780352453526,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T00:00:00Z","timestamp":1507593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T00:00:00Z","timestamp":1507593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Laparoscopic pancreaticoduodenectomy (LPD) is technically demanding, and its impact on postoperative outcomes remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare short\u2010term outcomes between laparoscopic versus open pancreaticoduodenectomy (OPD) in order to assess the safety of LPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2002 to 2014, all consecutive patients undergoing LPD or OPD at two tertiary centers were retrospectively analyzed. Patients were matched for demographics, comorbidities, pathological diagnosis, and pancreatic texture. Results for the two groups were compared for postoperative outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010five LPD were performed and compared to 290 OPD. In the whole population, postoperative pancreatic fistula (PF) was higher in the LPD group, but the proportion of ampullary ad\u00e9nocarcinoma (25 vs. 10%, <jats:italic>p<\/jats:italic> = 0.004) and soft pancreatic parenchyma (52 vs. 38%, <jats:italic>p<\/jats:italic> = 0.001) were higher in the LDP group. After matching (<jats:italic>n<\/jats:italic> = 65), LPD was associated with longer operative time (429 vs. 328\u00a0min, <jats:italic>p<\/jats:italic> &lt; 0.001) and lower blood loss (370 vs. 515\u00a0mL, <jats:italic>p<\/jats:italic> = 0.047). The PF rate and its severity were similar (33 vs. 27%, <jats:italic>p<\/jats:italic> = 0.439, <jats:italic>p<\/jats:italic> = 0.083) in the two groups. However, both complications (78 vs. 71%, <jats:italic>p<\/jats:italic> = 0.030) and major complications (40 vs. 23%, <jats:italic>p<\/jats:italic> = 0.033) were more frequent in the LPD group. LPD patients experience more postoperative bleeding (21 vs. 14%, <jats:italic>p<\/jats:italic> = 0.025) compared to their open counterparts. In multivariate analysis, perioperative transfusion (OR = 5 IC 95% (1.5\u201316), <jats:italic>p<\/jats:italic> = 0.008), soft pancreas (OR = 2.5 IC 95% (1.4\u20134.6), <jats:italic>p<\/jats:italic> = 0.001), and ampullary adenocarcinoma (OR = 2.6 IC 95% (1.2\u20135.6), <jats:italic>p<\/jats:italic> = 0.015) were independent risks factors of major complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite lower blood loss and lower intraoperative transfusion, LPD leads to higher rate of postoperative complications with postoperative bleeding in particular.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4269-z","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T18:36:34Z","timestamp":1507660594000},"page":"1138-1146","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Postoperative Bleeding After Laparoscopic Pancreaticoduodenectomy: the Achilles\u2019 Heel?"],"prefix":"10.1002","volume":"42","author":[{"given":"Sophie","family":"Chopinet","sequence":"first","affiliation":[{"name":"Department of Digestive Disease, Institut Mutualiste Montsouris Universit\u00e9 Paris\u2010Descartes 42 Boulevard Jourdan 75014 Paris France"},{"name":"Department of Digestive Surgery H\u00f4pital de la Conception Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fuks","sequence":"additional","affiliation":[{"name":"Department of Digestive Disease, Institut Mutualiste Montsouris Universit\u00e9 Paris\u2010Descartes 42 Boulevard Jourdan 75014 Paris France"},{"name":"Universit\u00e9 Paris Descartes 12 rue de l\u2019Ecole de M\u00e9decine Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Rinaudo","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery H\u00f4pital de la Conception Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Massol","sequence":"additional","affiliation":[{"name":"Department of Digestive Disease, Institut Mutualiste Montsouris Universit\u00e9 Paris\u2010Descartes 42 Boulevard Jourdan 75014 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Gregoire","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery H\u00f4pital de la Conception Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lamer","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Institut Mutualiste Montsouris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Belgaumkar","sequence":"additional","affiliation":[{"name":"Department of Digestive Disease, Institut Mutualiste Montsouris Universit\u00e9 Paris\u2010Descartes 42 Boulevard Jourdan 75014 Paris 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